基于六经皆有表证论治糖尿病性周围神经病

Treating Diabetic Peripheral Neuropathy Based on the Theory that All Six Meridians Possess Exterior Syndromes

摘要:

糖尿病性周围神经病（DPN） 是糖尿病的慢性并发症之一。李乐愚教授基于六经皆有表证论治DPN，提出该病核心病机以消渴日久、脏腑津血亏虚为本，风寒外邪侵袭六经、经络痹阻为标，属虚中夹表之证。以此构建DPN六经分证体系，划分太阳、阳明、少阳、太阴、厥阴、少阴六大表证，区分寒热虚实分型，以透发表邪、扶正通络为核心治法，灵活选用桂枝汤、当归四逆汤、附子汤等经方加减。临床验案证实该方案疗效稳定，为DPN的中医治疗拓展思路。

Abstract:

Abstract： Diabetic peripheral neuropathy （DPN） is one of the chronic complications of diabetes. Professor LI Leyu applied the theory that all six meridians possess exterior syndromes to treat DPN. He proposed that the core pathogenesis of this condition stems fundamentally from prolonged diabetes and deficiency of visceral fluids and blood， with external wind-cold pathogens invading the six meridians and causing meridian impediment-obstruction as the branch， constituting a syndrome characterized by deficiency complicated with exterior excess. Based on this， he established a six-meridian syndrome differentiation system for DPN， which categorizes the six major exterior syndromes—Taiyang， Yangming， Shaoyang， Taiyin， Jueyin， and Shaoyin， and differentiates the syndromes of cold， heat， deficiency， and excess. He flexibly employed modified classical formulas such as Guizhi Decoction， Danggui Sini Decoction，and Fuzi Decoction，with the core therapeutic principles of eliminating pathogenic factors and reinforcing healthy qi to unblock meridians. Clinically proven cases have demonstrated the stability of this treatment approach，thus providing a novel perspective for traditional Chinese medicine management of DPN.